1. BreathCaring Solidity There when you need HER. Now.
The new prisma STARS: SOFT & SMART
BreathCaring Solidity There when you need HER. Now.

2. BreathCaring Solidity.
prisma SOFT and prisma SMART
BreathCaring Solidity.
Discover the new generation of our CPAP/APAP device.
You'll make the right treatment choice with prisma SOFT or prisma SMART! The design for which prisma is known promises to deliver trusted quality. All our products are pragmatically designed for real-life use. For we always develop to satisfy our partners' requirements. We come up with state-of-the-art devices that feature reliability, intuitive use and economical operation.

3. “The CPAP/APAP with the best price/performance ratio on the market”
prisma SOFT and prisma SMART
Special Features
Proven good quality
(designed in Germany)
Recognized for good pressure constancy and algorithms (FOT APAP)
Long service life,
optimized TCO
“The CPAP/APAP with the best price/performance ratio on the market”
Basic Properties

4. prisma SOFT and prisma SMART
In brief: prisma SOFT and prisma SMART The all-rounders of OSAS therapy
Quality (sound, pressure, algorithms, service life) at well-known level for prisma devices
Modern design, usability rigorously tested and optimized
Titration still possible via prismaLAB
Proven comfort features such as softPAP, mask feedback, autoSTART, softSTART
Neu
Two different APAP dynamics
- For every patient the most suitable therapy -

5. What is new? Large LCD screen 2-step APAP User-friendly/GUI
prisma SOFT and prisma SMART
What is new?
Large LCD screen
Very clear, highly visible display of different kinds of information
Easy-to-understand
2-step APAP
Standard
Dynamic
The right therapy for every patient
User-friendly/GUI
Simple, clearly structured menu
User quickly understands the menu. No hidden content, no unnecessary displays
User-friendly/ handling
Standardized connections, prismaLINE accessories can be used
Compatible with existing accessories; titration can be done with prismaLAB

6. More Comfort Improves Compliance
prisma SOFT and prisma SMART
More Comfort Improves Compliance
softPAP 1 and 2 in CPAP and APAP
With pressure reduction during early phase of exhalation: especially for patients who find it unpleasant or difficult to exhale against positive pressure.
With pressure increase in time at the end of critical end-expiration phase to prevent obstructive events.
respiratory cycle
inspiration
expiration
flow
pressure
hPa
soft 1
soft 2

7. softPAP softPAP 1 softPAP 2 Current Pressure Reduction ≤ 8hPa -1.0hPa
prisma SOFT and prisma SMART
softPAP
softPAP 1
softPAP 2
Current Pressure
Reduction
≤ 8hPa
-1.0hPa
-2.0hPa
≤ 12hPa
-1.3hPa
-2.5hPa
≥ 12hPa
-1.6hPa
-3.0hPa

8. More Comfort Improves Compliance
prisma SOFT and prisma SMART
More Comfort Improves Compliance
prismaAQUA humidifier
Simple handling, easy to clean
Starts automatically when therapy begins
Automatically switches off when no water is available
400 ml capacity
Remove cover
Connect the humidifier
Open the humidifier

9. The world of prisma accessories
prisma SOFT and prisma SMART
The world of prisma accessories
can be expanded in all directions.
Integrated humidifier prismaAQUA (WM 29680)
Choice of tube systems: breathing tube, 19 mm (WM 24445) Optional: autoclavable tube system 19 mm (WM 24667), external heated tube system HYBERNITE Superday (WM 29045)
Filter: Pollen filter (set of 12 WM 29652) / Bacteria filter (WM 24476)

10. Handling
Expert Settings Menu
Hold down Menu button and softSTART button together for several seconds.
To call up the settings menu, press the button.

11. Algorithms in prisma SOFT and prisma SMART
New with 2 APAP dynamics: for every patient the most suitable therapy

12. Proactive APAP Regulation
prisma SOFT and prisma SMART
Proactive APAP Regulation
Challenge: Compromise between stable, therapeutically effective pressure and lowest pressure possible
Overly rapid / extreme reduction in pressure leads to renewed severe obstructions and arousals.
Overly rapid / extreme increase in pressure in response to mild obstructions leads to high mean pressures or high pressure variability (quick, renewed pressure reduction).
Inadequate increase in response to severe obstructions leads to longer phases with pressures below therapeutically effective levels.

13. FOT in all modes: The best way to identify different types of apnea
prisma SOFT and prisma SMART
FOT in all modes: The best way to identify different types of apnea
The automatic CPAP pressure regulation requires reliable information about apnea. When obstructive apnea is detected, the CPAP device increases pressure to prevent further obstructions.
In CPAP mode the information about apnea is essential for the user to determine whether the treatment is running well or if settings or even the mode should be changed.

14. prisma SOFT and prisma SMART
FOT: Functionality
With the help of Forced Oscillation Technology (FOT), our CPAP and APAP therapy devices reliably distinguish between obstructive and central apnea.
FOT is a sensitive process that uses the resulting air flow and pressures to measure the resistance and obstructions in the upper airways and then responds accordingly.
Pressure fluctuations
about 4 Hz, 0.4 cmH2O
cA: induced flow
oA: no flow

15. APAP settings: standard vs. dynamic
Select your preferred autoCPAP principle
prisma SMART
Low acceptance of higher pressures ! activate softPAP additionally
Side effects / leakage at higher pressures
Arousals due to pressure increases
-> OSA, mixed SA
APAP dynamic
APAP standard
Remaining sleepiness
High variability in pressure demand due to sleep stages, body position
-> OSA, UARS

16. APAP settings: standard vs. dynamic
Select your preferred autoCPAP principle
Pressure 1 2 3 4
P max 1
Period with oA, oH, RERAs 2
Period with flow limitations 3
Period with no events
P min 4
Period with snoring
Time
APAP dynamic:
APAP standard:
- Dynamic increase to prevent events with risk of desaturations / arousals
- Dynamic increase to prevent events with risk of desaturations / arousals 1 1
- Further, soft increase to gain safety margin and normalize flow conture
- No decrease to prevent re-occurence of severe events (increase in lowest quartile) 2 2
- Decrease of pressure, starting from an elevated level
- Decrease of pressure, starting from standard level 3 3
- Immediate response and high sensitivity to permanent snoring
- Epoch-based response (every 2 min) to permanent snoring 4 4
Maximum normalization of inspiratory flow shape and prevention of snoring
Safe prevention of severe events with cautious further increase to minimize side effects, optimize acceptance

17. APAP settings: P min Reasons to increase minimum pressure
prisma SMART
Pressure
P max T2
P min
Pressure range with known high oAHI
4 hPa T1
Time
Patients with generally high pressure demand
Shorter time with high oAHI (T2 vs. T1) -> lower residual AHI
Higher importance if critical pressure range has to be passed several times a night due to multiple therapy starts
-> Elevated AHI at lower pressure can be detected in pTS therapy analysis or in P(S)G report
-> Additional softSTART can help to fall asleep easier

18. APAP settings: P max Reasons to decrease maximum pressure
prisma SMART
Pressure
20 hPa
Pressure range with partial obstructions but known cAHI or non-acceptance
P max
P min
Time
Patients with significant impairment at higher pressures - even in a range with residual obstructive events
Leakage or non-compliance related to pressure
Central events / glottic apneas related to pressure
-> Pressure complications can be detected in pTS therapy analysis or in P(S)G report

19. Two APAP Dynamics You have the choice of two different
prisma SOFT and prisma SMART
Two APAP Dynamics
You have the choice of two different
settings for APAP management
Std (Standard):
Standard: APAP regulation of prismaLINE. Apnea and hypopnea are treated effectively. The device also responds to snoring, flattening and RERAs.
Target: Mean pressures and leakages are kept as low as possible.
dYn (Dynamic):
Dynamic: Stronger and faster reaction to snoring and flattening. Breathing is more rigorously normalized.
Recommendation:
For patients who benefit from higher pressures.
Will be implemented in the whole prismaLINE portfolio with a next FW Update

20. Standard APAP: Algorithm Details
prisma SOFT and prisma SMART
Standard APAP: Algorithm Details
Objective of the epoch principle: adjustment time to new pressure
An epoch = 2 minutes
Pressure change at end of epoch
obstructive Hypopnea (oH) and obstructive Apnea (oA): immediate reaction, up to two times within an epoch
eSO events: oA, oH, Snoring > 8 breaths in the epoch
eMO events: RERA, Snoring > 4 breaths in the epoch
eSO: Epoch with severe obstruction
eMO: Epoch with mild obstruction
eFL: Epoch with high share of flow-limited breaths
eSO
eMO
eFL
eSO – severe obstruction
eMO – mild obstruktion
eFL - Flattening

21. Dynamic APAP: Algorithm Details
prisma SOFT and prisma SMART
Dynamic APAP: Algorithm Details
Objective of the epoch principle: adjustment time to new pressure
An epoch = 2 minutes
Pressure change at end of epoch
Immediate reaction, up to two times within an epoch, to snoring (after 6 breaths), obstructive Hypopnea (oH) and obstructive Apnea (oA)
eSO events: oA, oH, Snoring > 6 breaths in the epoch
eMO events: RERA, Snoring > 3 breaths in the epoch
eSO: Epoch with severe obstruction
eMO: Epoch with mild obstruction
eFL: Epoch with high share of flow-limited breaths
eSO
eMO
eFL
eSO – severe obstruction
eMO – mild obstruktion
eFL - Flattening

22. APAP: Algorithm Details
prisma SOFT and prisma SMART
APAP: Algorithm Details
Pressure range (Pmax-Pmin) is divided into four quartiles
Dynamic reactions depend on pressure range
Example: Pmax 18 hPa, Pmin 10 hPa
1st Q: hPa
2nd Q: hPa
3rd Q: hPa
4th Q: hPa
eSO
eMO*
eFL*
Std
dYn
1st Quartile
1.5hPa
1.0hPa
0.5hPa
2nd Quartile
--hPa
3rd Quartile
0.2hPa
4th Quartile
Pressure increase depends on event * max. Increase 4 hPa above eSO pressure

23. Positioning prisma STARS (OSAS)
Best Handling, Known Algorithms
Segment
Device
Differences
Premium Segment
(e.g. private patient)
prisma20A,
prisma20C
Most intuitive way of handling: touch
Integrated heating tube
Inspirational breathing support
Humidifier level 7
FOT / CSR
Typical, classic OSAS segment
prisma SOFT,
prisma SMART
LCD
softPAP-Level 1-2 (exhalation relief)
Humidifier level 5
2 APAP dynamics
Exclusively quote driven / tender
SOMNObalance,
SOMNOsoft 2
Micro LDC
softPAP Level 1-2 (exhalation relief)
OPP
“The CPAP/APAP with the best price/performance ratio on the market”

24. BreathCaring Solidity There when you need HIM. Now.